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Neck Pain in Cyclists can be Prevented with Good Posture &Technique

Posted Apr 19 2009 11:46pm

I recently came accross a health article by Dr.Asplund- a medical Doctor in DC who is an avid cyclist. He discusses ways to prevent neck pain while cycling.

Dr.Asplund states that neck pain among cyclists in common- whether occasional or recurrent. Often times this neck pain is more common early in the cycling season. He suggests that in "to avoid early season overuse injuries, riders should initially ride at high cadence and low resistance and only increase training mileage by 10% weekly, gradually building to goal mileage".

Cycling and neck pain Dr.Asplund notes that riding position technique can play a role in preventing Neck pain. He notes that the type of bike is a factor: For example, riding in drop handlebars for long periods increases the load on the arm and shoulders as well as hyperextension of the neck, leading to pain. If the virtual top tube length (top tube plus stem length) is too long for the rider, or if aero bars are used, hyperextension of the neck is further increased. Having a bike properly adjusted for your height, weight and frame are important for comfort.

Keeping your head extended (position of when you are looking up at the ceiling) for a long period of time can cause muscle spasm, especially trigger points. The muscles of the neck such as the suboccipitals and the cervical paraspinals may be affected. "Trigger points are small rubbery knots that form in muscle and adjacent muscle sheaths (fascia), which may send pain signals to the brain and contribute to a pain-spasm-pain cycle. Trigger points are frequently caused by direct blunt trauma, or by repetitive micro trauma, as is seen in overuse athletic injuries" Dr. Asplund stated.

Dr. Asplund goes on to give advice to prevent neck pain while cycling:

  • One way to reduce neck hyperextension is by raising the handlebars, or using handlebars with a shallower drop.
  • Reduce the virtual top tube length, by using a stem with a shorter extension. Moving the saddle forward would also reduce virtual top tube length, but the rider should be cautious as improper fore/aft saddle position can lead to knee pain.
  • Changes to riding technique can also help with neck pain. Rigid riding position transmits more shock directly to the neck and shoulders.
  • Riding with unlocked elbows and changing hand position (i.e. from drops to brake hoods) can alter neck posture minimizing pain.
  • The rider may also alter his head position during the ride, in essence stretching the neck muscles while riding.


Riders whose neck or back pain is refractory to the above techniques should decrease their weekly mileage by 10% until the back pain disappears. During this period of mileage reduction, they should also avoid climbing and sprinting, and use a high cadence, low resistance spinning technique. Ice and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, may be used to provide pain relief. NSAIDs should be taken with food, and if the pain is not resolving within 1 week, medical evaluation is recommended. Medical management may include continuation of NSAIDs, trigger point injections, and possible a referral for physical therapy to improve core strength and flexibility.

In summary, although neck and back problems are very common, they can usually be managed by a combination of bicycle adjustment, technique change, and minor medical treatment.

Article Source: Neck Pain and Back pain with Cycling

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